A widely used abortion medication will continue to be available by mail nationwide for at least the next three days, according to a brief order issued on Monday by Justice Samuel A. Alito Jr.
The Supreme Court is currently considering an emergency request to halt a lower-court ruling that would make it more difficult for women throughout the country to access the medication mifepristone.
Justice Alito, who oversees such requests from the U.S. Court of Appeals for the Fifth Circuit, extended a pause on that court’s ruling that he first ordered last week until 5 p.m. on May 14, suggesting that the full Supreme Court was still deliberating how to resolve the matter.
The order, known as an administrative stay, will allow health care providers, for now, to continue to prescribe the pill by telemedicine and to deliver the medication to pregnant women by mail, a major avenue for abortion access throughout the country.
The justices are considering a request from two mifepristone manufacturers that rushed to the Supreme Court after the conservative U.S. Court of Appeals for the Fifth Circuit restricted access to the pills. The Fifth Circuit reimposed a requirement that patients obtain the medication only after seeing a provider in person. That requirement was first lifted in 2021, making it possible for people in Louisiana and other states with abortion bans to receive the pills through the mail.
Louisiana officials sued the Food and Drug Administration, seeking to revive the restrictions, which the state says have undermined its near-total ban on abortion.
Although the Supreme Court overturned Roe v. Wade in 2022, eliminating the nationwide right to abortion, the clash over the issue has continued in the courts and puts the Trump administration in a difficult position.
Justice Department lawyers have not said in court proceedings or publicly whether they back regulations that allow people to be prescribed the pills through telehealth appointments. Instead, they have asked the lower courts to pause the litigation to give the F.D.A. time to complete a review of the safety of mifepristone, which was first approved in 2000.
Administration officials did not respond to requests for comment about the Fifth Circuit ruling this month, and the Justice Department made the unusual decision not to file at the Supreme Court after the F.D.A., which it was defending, lost in the appeals court. Ordinarily, the justices would hear from the federal government when it has been a party in a case.
Nearly two-thirds of abortions in the United States are now carried out with abortion pills and about one quarter rely on telemedicine. The Louisiana case targets mifepristone, the first of what is typically a two-drug regimen. The second medication, misoprostol, is not affected by the Fifth Circuit ruling.
Louisiana has asserted in its lawsuit that the F.D.A.’s decision to remove the in-person dispensing requirement was based on inadequate or flawed data — a claim medical organizations dispute, pointing to more than 100 studies that have found that mifepristone is safe, and that serious complications from taking it are rare.
Allowing the pills to enter Louisiana by mail, the state says, has also increased health care costs when women experience complications.
Two manufacturers of mifepristone, Danco Laboratories and GenBioPro, asked the Supreme Court to intervene this month to restore nationwide access to the pill by mail. The Fifth Circuit’s ruling in Louisiana’s favor, they told the justices in filings, could disrupt the broader pharmaceutical industry and lead to state-by-state second-guessing of all sorts of drug regulations.
The companies also told the Supreme Court that the harms cited by the state are too indirect and insufficient to establish grounds to allow it to sue. They pointed to the Supreme Court’s 2024 decision in which the justices unanimously rejected a similar attempt to restrict access to mifepristone in a case brought by antiabortion physicians.
Justice Brett M. Kavanaugh, writing for the court in that case, said the doctors did not have legal grounds to sue because they did not prescribe mifepristone and had not suffered any direct harm from the F.D.A.’s loosening of regulations for obtaining the drug.
Ann E. Marimow covers the Supreme Court for The Times from Washington.
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